SAN DIEGO—Patients with any form of hypernatremia have increased risks of early death, according to study findings presented at Kidney Week.
Nicolaos E. Madias, MD, FASN, and colleagues of St. Elizabeth’s Medical Center in Boston, sought to understand the effects of hypernatremia in an unselected population, so they analyzed the discharge data of 20,072 patients from a tertiary care facility. Hypernatremia was defined as sodium levels above 142 mEq/L.
Community-acquired hypernatremia (CAH) occurred in 20% of hospitalized patients and was associated with a 67% increased risk of in-hospital mortality, compared with patients who had normal sodium levels (138-142 mEq/l). CAH patients also had a 10% longer length of stay and were 44% more likely to be discharged to a short- or long-term care facility.
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Likewise, hospital-acquired hypernatremia developed in 25.9% of hospitalized patients and was associated with more than triple the risk of in-hospital mortality. Length of stay was 49% longer than for patients with normal sodium levels. The likelihood of discharge to a care facility was 45% greater.
Researchers further found that hypernatremia worsened during hospitalization for 8.9% of CAH patients. Aggravation was associated with greater risks of in-hospital mortality (84%) and discharge to a facility (90%). Length of stay was also 13% longer for these patients.
“Development or worsening of hypernatremia in the hospital is an indication of suboptimal care,” Dr. Madias told Renal & Urology News. “We need to develop ways to prevent these occurrences.” Future studies are needed to determine if the relationship between hypernatremia and adverse clinical outcomes is simply associative or causative, even in part.
